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心内科临床过度使用临床化学实验室检验:一项单中心研究。

Clinical chemistry laboratory test overuse in a cardiology clinic: a single-center study.

机构信息

Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

J Med Life. 2023 Apr;16(4):540-545. doi: 10.25122/jml-2022-0338.

Abstract

Diagnostic laboratory tests are frequently overused in healthcare entities, leading to an increased strain on laboratory resources, additional workload, and wastage of resources. Continuous monitoring of test ordering behavior is crucial to evaluate clinical necessity. This cross-sectional study aimed to estimate the necessity of ordering clinical chemistry tests in the cardiology clinic of a tertiary center in Saudi Arabia. We retrieved medical records of patients diagnosed with cardiovascular problems admitted at the cardiology clinic in 2020. The frequency and percentages of the ordered tests were calculated upon admission and follow-up, and the difference between necessary and unnecessary tests was compared for each category. Test ordering assessment included cardiac, renal, and liver functions, blood gases, thyroid and diabetic profile, iron indices, hormones, water and electrolytes, and inflammatory markers. The results showed a large number of clinical chemistry tests ordered without clinical necessity. While the number of necessary tests was significantly higher than that of unnecessary tests, 21% of the tests ordered between June-December 2021 at the center were unnecessary. Further studies are necessary to identify driving factors and develop strategies to reduce the overutilization of diagnostic laboratory tests in clinical practice. Eliminating this phenomenon will reduce the risk of unnecessary medical interventions and associated costs, improve patient outcomes, and reduce the overall burden on the healthcare system.

摘要

诊断实验室检测在医疗保健机构中经常被过度使用,导致实验室资源的负担增加、额外的工作量和资源浪费。对检测开单行为进行持续监测对于评估临床必要性至关重要。本横断面研究旨在评估沙特阿拉伯一家三级中心心内科临床化学检测的开单必要性。我们检索了 2020 年心内科就诊的心血管疾病患者的病历。计算了入院时和随访时的检测频率和百分比,并比较了每个类别中必要和不必要检测之间的差异。检测开单评估包括心脏、肾脏和肝脏功能、血气分析、甲状腺和糖尿病指标、铁指标、激素、水和电解质以及炎症标志物。结果显示,大量的临床化学检测是在没有临床必要性的情况下开单的。虽然必要检测的数量明显高于不必要检测的数量,但 2021 年 6 月至 12 月中心开单的 21%检测是不必要的。需要进一步研究以确定驱动因素,并制定策略来减少诊断实验室检测在临床实践中的过度使用。消除这种现象将降低不必要的医疗干预和相关成本的风险,改善患者的结局,并减轻医疗保健系统的整体负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e562/10251380/bed7eb98650b/JMedLife-16-540-g001.jpg

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